spotlight on women & babies

spotlight on WOMEN& BABIES

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Issue 8 – Fall 2009

Welcome to the eighth edition of Spotlight on Women & Babies, a newsletter for staff in Sunnybrook’s Women & Babies Program.

You’ll find updates on M-wing construction as well as news of interest to staff and patients in the program.

If you have any suggestions for future content, please drop a line to marie.sanderson@sunnybrook.ca or call 416.967.8554.

Ready or Not, Here We Come!

Women & Babies Move Set for Sunday, September 12, 2010

Jo Watson, Operations Director for the Women & Babies Program and

Dr. Andy Shennan, Program Chief for the Women & Babies Program

reveal the stork’s special message: the Program will move into its

new home at the Bayview campus on Sunday, September 12, 2009.

The team celebrates the announcement of the official move date for

the Women & Babies Program.

Photos by Doug Nicholson.

M-wing Construction is Over 85 Per Cent Complete

Construction of the new facilities for the Women & Babies

Program on M4 and M5 at the Bayview campus is over 85 per

cent complete. Ed Bush, Senior Project Manager in Corporate

Planning and Development provides a unit-by-unit rundown of the

construction at the Bayview campus:

Neonatal Intensive Care Unit (NICU): All partitions are in place

with the first coat of paint. Flooring is down, doors are being

installed and light fixtures are in place within the new ceiling grid.

Tile work is nearing completion behind the sinks in patient rooms.

Millwork is in progress for parents’ sleeping benches and lockers.

Installation of articulating arms is in progress throughout the area.

Work has started on the NICU Staff Lounge, in conjunction with

the installation of the last sections of the exterior glass, finally

possible with the removal of the construction hoist from the east

end of the building. In the NICU Pharmacy, casework is being

installed and new systems furniture are going in.

Continued on page 2

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Labour, Birth, Recovery and Postpartum (LBRP): The LBRPs

are proceeding quickly, with flooring installation underway, millwork

nearing completion and washroom fixtures being installed. All tiling

in the washrooms is complete, doors are being installed and work

has started on the last two LBRPs at the east end of the building.

Systems furniture for the nursing station is also under way.

Operating Rooms: Ceilings are installed, light fixtures and wall

finishes are completed and the construction crew is preparing to

start the epoxy flooring for the ORs. Flooring in the sterile area

corridor is complete.

A new room for Labour, Birth, Recovery and Postpartum (LBRP)

Look up!

M-wing Galleria Opens Up

As all of the work in the galleria between the 4th to 7th floors is

nearing completion, the contractor has removed the access

scaffolding located above the temporary galleria platform.

Removal of the galleria platform will begin in December. This

means that when staff, patients and visitors enter the M-wing,

they’ll be able to look all the way to the top and see the

impressive work done to date!

A new NICU room An exterior look at the M-wing construction project.

Continued from page 1 High Risk Antenatal Unit: All rooms in the unit are well under

construction, with flooring complete, headwalls installed and

finishes for washrooms nearing completion. Ceiling installation is

underway allowing the installation of lighting fixtures.

Combined Care Unit: Walls for all of the patient rooms are

completely installed, drywall is finished with the first coat of paint,

ceilings are underway, headwalls and flooring are installed and

millwork installation has started, including lockers for patients.

Ambulatory High Risk: All partitions have been built, flooring is

going down and ceilings are being installed.

M-wing Construction is Over 85 Per Cent Complete

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Transition committees have been busy planning for the move to

the Bayview campus in September 2010. Here is a snapshot of

the work of the various transition team sub-committees.

Equipment Committee – The Equipment Committee is preparing

evaluation forms for the items that will be trialed this fall. This

includes over-bed tables, bassinettes, case carts, gyne stretchers

and OB-TVs (fetal monitoring system). The IV Smart Pumps went

live on September 29, 2009 in the Birthing Unit and the NICU will

go live in the spring. New pain pumps (PCA/PCEA) are being

investigated and will hopefully be implemented by the spring.

The NICU has chosen a vendor for their monitors and they will be

installed in the new nursery.

Staffing Committee – The Staffing Committee is in full swing

assessing the orientation and learning needs of all Women & Babies

Program staff. There will be a general orientation for all staff next

summer at the Bayview campus. As the program is changing the

model of care in the Birthing Unit and the NICU, staffing education

needs have changed. Cross-training of nursing staff is almost

complete, with all Birthing Unit nurses completing their Maternal

and Newborn Unit sessions. Four postpartum nurses who were

cross-trained in the Birthing Unit will continue in that unit. Work in

the NICU is focused on preparing for the move from an open bay

NICU to a single room model. The NICU has many new staff over

the past year and orientation is nearing completion.

Obstetrical nurses are continuing to enroll in the Critical Care

Program at George Brown College. To date, eight nurses have

completed the program, which included shifts in the CrCU, CVICU,

and soon the Emergency Department at the Bayview campus.

Seven nurses are enrolled this year. The program is proud to

be holding Journal Clubs which focus on applying critical care

knowledge to the field of obstetrical care.

Communications Committee – The committee has been

examining the communication needs of the Program with the goal of

eventually having a communication tool that will increase efficiency,

ensure safety and save time in our new home. Two members of

the committee are also creating a master list of all the contact

information for Women & Babies Program staff and updating it to

include new contact information after the move. The committee

is also implementing “huddles” twice daily between the NICU,

Birthing Unit and the High Risk Antenatal Unit to ensure timely and

accurate information-sharing is actively in place prior to the move.

Memories and Celebrations Committee – A fundraising walk

marking the move of the Women & Babies Program will be held

next August 22nd, 2010. The walk will coincide with the 30th

annual Preemie Picnic, a celebration for NICU graduates, their

families and staff. The plan is to walk from Queen’s Park (right

around the corner from 76 Grenville) to the Bayview campus

where we will join the Preemie Picnic and make it a huge

celebration. We want to make this a great fundraising success

while marking this memorable occasion. The committee will be

reaching out to families and staff to encourage them to join in

our journey.

Processes Committee – The committee continues to identify

processes that will change with the move and those that will

need modification as the model of care changes.

Family Practice Committee – Family Practice Departments from

Sunnybrook and Women’s College Hospital have been meeting

monthly to determine how they’ll work together in the new space

at Bayview Avenue.

Ambulatory Planning Update – Gynaecology, low-risk

obstetrics and urogynaecology will be located in B6 and B7.

Planning is underway with physicians and construction will start

shortly.

Maternal Fetal Medicine Medical Liaison Committee

(MFMMLC) – Meetings have taken place with representatives

of the medical subspecialties, including endocrine, renal and

other sub-specialties, to determine the logistics of consults

within the program.

Emergency Department Committee – Obstetrical and Neonatal

Guidelines are being drafted by the committee for Emergency

Department staff to use as a reference. Nurse educators Leigh

Andrews and Cheryl Philips have been holding educational

sessions with Emergency Department nursing staff, addressing

issues such as precipitous deliveries and neonatal resuscitation

that may occur in the Emergency Department.

Transition Committee Update

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Dr. Herbert Wong performed a laparoscopic hysterectomy on

November 18, 2009 that was broadcast live to the annual meeting

of the American Association of Gynecologic Laparoscopists

(AAGL) in Orlando, Florida. The procedure, assisted by Dr.

Romy Nitsch and Dr. Janet Bodley, demonstrated laparoscopic

hysterectomy using laparoscopic suturing techniques for all

major vascular pedicles. This operation is often done using

costly staplers, but using sutures, while more cost-effective,

requires a higher degree of surgical skill and can take a less

expert surgeon more time. Sunnybrook has the largest minimally

invasive gynaecology surgery group in the province, with a

focus on the removal of fibroids (myomectomies), treatment of

advanced endometriosis, incontinence procedures and pelvic

floor reconstruction. The AAGL has a membership extending

to 31 countries and is an internationally recognized authority in

minimally invasive gynecology. There were only five live tele-

surgery cases presented at the conference: three from American

centres, one from Taiwan, and one from Toronto. Congratulations

to Dr. Wong on this honour!

Sunnybrook to Provide 765 New Staff Parking Spots

A new parking garage under construction at the Bayview campus

will provide 765 new parking spots reserved for Sunnybrook staff.

To be completed in June 2010, the garage is located near the

helipad in the east end of the hospital grounds and will bring the

total number of parking spaces for staff to 2515.

“We want to provide as many options for staff when it comes to

parking,” says Solomon Ayeneababa, Manager of Parking and

Transportation Services at Sunnybrook. “Women & Babies staff

will have the option of purchasing a monthly staff parking permit

or a pay-per-use pass which will allow them some flexibility.”

Details on the types of staff parking options can be found on

Sunnynet, under “Facility Services” and then “Parking and

Transportation Services”. Parking and Transportation Services

is also looking at other ways to meet the needs of the increased

staff at the Bayview campus next fall, including adding additional

shuttle buses, possibly to and from Union Station during peak

hours. Stay tuned for more details!

Excellence in Laparoscopic Surgery

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NICU Grad of ’57 Tours the Unit

Marion Deland, Patient Care Manager in the NICU, speaks with mother

Jean Bradley and daughter Cheryl Kallaste, an NICU graduate from

1957. The birth of Cheryl made front-page news when she was born at

30 ounces. Nicknamed “Pee Wee”, Cheryl spent three months in the

NICU and was eventually discharged at 5 pounds, 12 ounces. Mother

and daughter presented the unit with framed copies of news articles

from 1957, focused on Cheryl’s birth and discharge from hospital.

H1N1 Update

From a frequently-asked-question segment on the website, to

a webcast and links to local public health vaccination clinics,

Sunnybrook has been providing our patients and the public with

useful background on pregnancy and the H1N1 virus and H1N1

vaccine.

In early November, the Women & Babies Program began to

vaccinate its pregnant patients. A special thanks to Donna Brown

for helping to organize the vaccination program.

W&B Staff Give Back

Keep your eyes peeled for new ways to give back to the hospital…

the Women & Babies Program has launched several fun new giving

opportunities for staff, including:

• Miglio Designer Jewelry – Staff purchasing items from Miglio

designer jewelry from South Africa will be helping to purchase

equipment for the program’s new home at the Bayview

Campus. Ten per cent of each purchase will be donated to

the Women & Babies Program. Not only do you take home

gorgeous jewelry, but you’re doing it for a great cause!

To view some of the jewelry, please visit www.miglio.com. If

you’ve missed any of the scheduled sales, please contact

Lynnette Eisen at: 705-720-2811 or 705-627-9118 or email

lynnette.eisen@rogers.com

• Change for Change – Don’t forget to drop your spare change

in one of the boxes in the NICU, High Risk Antenatal Unit,

Birthing Unit and Maternal and Newborn Unit. Every little bit

helps, so make sure you collect your change to support the

program.

• Goodies Baskets – Over the coming months, goodies baskets

will be raffled off by each unit and by various disciplines in

the Women & Babies Program. For just $5 for three tickets,

you can enter for a chance to win fun baskets. All proceeds

go directly back to the program.

• W&B Cookbook – Jean Chow and Davina Douglas will be

taking the lead on the Women & Babies cookbook, featuring

staff recipes. This cookbook will be sold to staff, patients and

the community to raise money for the program. Stay tuned

for more details!

• NICU Holiday Bazaar – There will also be a NICU Holiday

Bazaar on Monday, December 21, 2009 from 8 a.m. to 4 p.m.

in the main lobby at 76 Grenville Street. For more information

on how to donate, please email amanda.squires@sunnybrook.ca

Farwell and Welcome…

Biz Westcott accepted the role of Patient Relations

Consultant in the Patient Relations Office at the Bayview

campus in September 2009. Biz was most recently Patient

Care Manager in the Maternal & Newborn Unit. In her new

role, Biz will be responsible for investigating and following

up on patient concerns. We wish her all the best.

With Biz’s departure, Monica Nicholson has accepted the

role of Patient Care Manager for the Maternal and Newborn

Unit, as well continuing with her role as PCM for the Birthing

Unit.

Aimee Santoro has accepted the administrative leadership

role for the Gynaecology Clinic and 6E until the program

relocates to Sunnybrook. Aimee’s office is in Room 619 and

her phone number is 323-6400 x4438. Aimee will continue

in the role of Nurse Practitioner for the program.

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Campaign for Sunnybrook:

Women & Babies Program Display Draws Staff, Donor and

Community Interest

Mother Kate Robson with daughter Maggie, who was born at

Sunnybrook in 2005 at 25 weeks and just 500 grams or one pound,

one ounce.

Kathryn Fowles and baby Sebastian, an NICU graduate, celebrate the

campaign launch.

The Women & Babies Program display.

Photos by Doug Nicholson.

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Campaign for Sunnybrook:

Women & Babies Program Display Draws Staff, Donor and

Community Interest

Laura Borges, NICU nurse, Marion Deland, Patient Care Manager in

the NICU and Monica Nicholson, Patient Care Manager for the Birthing

Unit, speak with members of the community at the Women & Babies

Program display.

HPV in the News

Aimee Santoro, Nurse Practitioner, administers the HPV vaccine.

Photo by Doug Nicholson.

Sunnybrook received several media requests regarding HPV and

the HPV vaccine during the fall. Dr. Jennifer Blake spoke with

Global-TV, CTV and CBC-TV The National on the importance of

vaccination and to promote Ontario’s Grade 9 vaccination program.

Media coverage sparked interest from Queen’s Park members,

where George Smitherman sponsored a media briefing for Cervical

Cancer Awareness Week at Queen’s Park featuring Dr. Blake.

The Sunnybrook Foundation announced the public phase of the

Campaign for Sunnybrook on Monday, November 2, 2009, in

M7, the future home of the Centre for Research in Image-Guided

Therapeutics. As part of the launch, programs hosted interactive

displays demonstrating how Sunnybrook saves lives with

innovation. The Campaign for Sunnybrook is a $470 million effort

to bring the space, technology, colleagues and flexible funding

that the hospital’s health care teams need to save lives and invent

the future of health care. To date, $265 million has been raised.

The Women & Babies Program display highlighted “A Woman’s

Journey to Motherhood”, including a gynaecology component,

an obstetrical mannequin with twins and neonatal isolette. Thank

you to the staff who graciously volunteered for the two-day

launch: Laura Borges, Deb Cull-Hollingsworth, Marion Deland,

Erin Limerick, Elizabeth MacMillan-York, Monica Nicholson and

Aimee Santoro.

Painting a True Picture of

Canada’s Maternal Mortality and

Morbidity RatesIt is commonly acknowledged that Canada has one of the lower

maternal mortality and morbidity rates in the world. But, digging

deeper, experts admit that accurate Canadian data on death and

severe illness during pregnancy, childbirth and postpartum is less

than optimal. Existing databases do not allow accurate collection

of maternal mortality or morbidity rates on a national basis. There

is an urgent need for a reliable mechanism to collect this form

of data in Canada, particularly in light of the nation’s increasing

Caesarean section rate which is very likely to be associated with

operative and other complications.

On Wednesday, December 2, 2009, a small working group with

international representation met with the goal of promoting

accurate data collection on maternal mortality and morbidity rates.

This group, led by Dr. Jon Barrett from Sunnybrook, an advisory

member to the World Health Organization (WHO), documented

the next steps for improving data collection. This includes pushing

for every hospital in Canada to use a simple, web-based software

program developed by the WHO that allows reliable data collection

on maternal mortality and “near miss” maternity mortality.

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Spotlight on Research

Another example currently in development is the Journey to

Home Discharge Checklist. This is a birth to transfer or discharge

communication tool that was designed by families and staff to

support the families’ transition to either home or transfer to a Level

2 peripheral unit. The goal of the checklist is to empower parents

and families in learning to how to care for their baby.

The initiatives are paying off. In the 2008 Transfer Survey, 75 per

cent ‘strongly agreed’ to the statement “Overall I was satisfi ed

with the care my baby received while in the NICU” and 25 per

cent ‘agreed’. In the 2008 Discharge Survey 82 per cent ‘strongly

agreed’ to the statement “Overall I was satisfi ed with the care my

baby received while in the NICU” and 18 per cent agreed.

Survey questions are reviewed annually for clarification and

accuracy, with changes made based on input from families.

Comparisons are made within similar questions over time and

revised questions are introduced as new themes emerge, so

that an ongoing evaluation of the survey truly refl ects families’

perceptions in “real time”. Current survey questions address

issues related to our new NICU.

“These initiatives are a team effort between families and the unit’s

multidisciplinary staff, and result from always trying to fi nd ways

to increase effective communication between parents and families

and the NICU health care team. By giving families many ways to

communicate with us and provide feedback, like the survey, we

can achieve a much higher level of family satisfaction and patient

safety,” adds Laura Borges.

Sunnybrook’s NICU won the Quality and Patient Safety Award at

the 2008 Annual Partners in Paediatric Patient Safety Symposium

hosted by The Hospital for Sick Children.

The NICU Post Transfer and Discharge Surveys reveal that families

are very satisfi ed with the care their babies received in the NICU

during the period from 2006 to 2008. The survey was designed

with a dual purpose: to help build a trusting relationship and to

enhance communication between families and the health care

team. Results show high levels of satisfaction with information

sharing between the NICU team and families; families’ involvement

in their baby’s care and family involvement in decisions regarding

their baby’s discharge and transfer.

Created in 2003, the survey is part of the NICU’s involvement in

“Family Matters”, a Vermont Oxford Network Quality Improvement

Collaborative on Family Centred Care. Designed specifi cally for the

NICU environment, the results are used as a catalyst for evaluation

and improvement. Comprised of 30 questions, the telephone

survey is conducted by the unit’s Registered Nurses and includes

the opportunity for qualitative feedback from families. In 2008,

76 per cent of families completed the transfer survey and 78 per

cent completed the discharge survey.

“What makes this survey so powerful is that families’ responses

actually lead to change and improvement,” says Laura Borges, an

R.N. in the NICU and member of the Quality Assurance Committee

in the NICU. “We were hearing from families that they weren’t feeling

fully prepared for their baby’s transfer to another hospital. One of

the many ways we have improved families’ preparedness with the

transfer process was the creation of the Readiness for Transfer

Checklist. This was developed as a visual cue to give families a good

sense of when their baby is medically ready for transfer to a level 2

nursery closer to the family home. We hope to utilize this checklist

further, by adding a ‘Red, Yellow, Green, Go’ feature when we move

to new unit at the Bayview campus in 2010. This has the potential

to improve families’ knowledge and their level of preparedness

regarding their infant’s medical readiness for transfer or discharge.”

1. H1N1 and Pregnancy Registry: The Women & Babies

Program is collecting data on the outcome of pregnancies

after vaccination for the H1N1 virus. Led by Dr. Jennifer

Blake, the H1N1 registry for the fall and winter of 2009 is

open to all obstetrical patients at Sunnybrook.

2. “Comparison of Abdominal Musculature Thickness

in Postpartum and Nulliparous Women”: This study,

led by Dr. Jon Barrett, will look at the abdominal muscles

after pregnancy in Sunnybrook’s obstetrical patients

between the ages of 20 and 40 years. Abdominal muscles

alternately thicken or thin during pregnancy and this study

will determine the impact on back pain.

NICU Family Survey Leads to Change and Improvement

Family Satisfaction High in the NICU